Evidence map›Paper›PMID 41697454›Full record

ArticleInternational ophthalmology2026

Comparative analysis of 70 SMILE and 70 toric ICL eyes for myopic oblique astigmatism: a matched cohort study from an initial pool of 11,929 eyes.

Abdelrahman Assaf, Baha A Alsaify, Leonie Troeber, Amir Javadi, Rainer Wiltfang, Martin Bechmann, Klio Becker, Nikolaus Feucht

Abstract readComparative Study
In one paragraph

Article in International ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Abdelrahman AssafSmile Eyes Eye Clinic, Munich Airport Center, Munich, Germany. abdalrhmanassaf@gmail.com.ORCID http://orcid.org/0000-0002-9350-2645
Baha A AlsaifyNetwork Engineering and Security Department, Jordan University of Science and Technology, Irbid, 22110, Jordan.
Leonie TroeberSmile Eyes Eye Clinic, Trier, Germany.
Amir JavadiSmile Eyes Eye Clinic, Munich Airport Center, Munich, Germany.
Rainer WiltfangSmile Eyes Eye Clinic, Munich Airport Center, Munich, Germany.
Martin BechmannSmile Eyes Eye Clinic, Munich Airport Center, Munich, Germany.
Klio BeckerSmile Eyes Eye Clinic, Munich Airport Center, Munich, Germany.
Nikolaus FeuchtSmile Eyes Eye Clinic, Munich Airport Center, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare visual, refractive, and vector-based astigmatic outcomes between Small Incision Lenticule Extraction (SMILE) and toric Implantable Collamer Lens (ICL) implantation in patients with myopic oblique astigmatism.

methodsIn this retrospective, matched cohort study, 140 eyes (70 SMILE, 70 toric ICL) with oblique astigmatism were treated at a single center. Groups were matched preoperatively for refractive cylinder and spherical equivalent within ± 0.50 D. Postoperative outcomes at six weeks were assessed, including uncorrected and corrected distance visual acuity (UDVA, CDVA), spherical equivalent (SEQ), astigmatism correction using vector analysis (Alpins method), and safety and efficacy indices. A post hoc power analysis was performed for the astigmatic correction index.

resultsThe efficacy index was 0.97 ± 0.17 in the ICL group and 0.94 ± 0.15 in the SMILE group. The safety index was 1.02 ± 0.11 (ICL) versus 1.01 ± 0.09 (SMILE). UDVA equal to or better than preoperative CDVA was achieved in 83% of ICL eyes and 79% of SMILE eyes. SEQ within ± 0.50 D was observed in 85.7% (ICL) versus 81.4% (SMILE). The astigmatic correction index was 0.97 for ICL and 1.04 for SMILE. Linear regression showed stronger correlation between target and achieved astigmatism in the ICL group (slope = 1.04, R

conclusionsBoth SMILE and toric ICL are effective and safe for correcting myopic oblique astigmatism. However, toric ICL demonstrated slightly greater precision in axis alignment and refractive predictability, supporting its use in cases of high oblique astigmatism where rotational accuracy is critical.

Indexed as

AstigmatismCorneal Surgery, LaserLens Implantation, IntraocularMyopiaPhakic Intraocular LensesRefraction, OcularVisual AcuityAdultFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeYoung AdultEVO + ICLTMOblique astigmatismPhakic intraocular lenses(pIOLs)Small incision lenticule extractionSMILE

Identifiers

PMID41697454
PMCPMC12909438

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.